Infectious Diseases Unit, Internal Medicine Ward, Health Area of Ferrol, Sergas, La Coruña, Spain.
Enferm Infecc Microbiol Clin. 2011 Aug-Sep;29(7):502-9. doi: 10.1016/j.eimc.2011.03.005. Epub 2011 May 12.
To describe the epidemiology and risk factors associated with extra-pulmonary tuberculosis (EPTB).
Cases of tuberculosis (TB) diagnosed from 1991 to 2008 in a Caucasian population were classified as EPTB or pulmonary TB (PTB). Of all cases, 63.7% were followed up in a specialist TB unit. A standardised protocol for data collection was used, including: gender, age, BCG vaccination, contact with PTB patient, smoking habit, alcohol abuse, diabetes mellitus, immunosuppressive drugs/steroids and HIV-status. These variables were compared between EPTB and PTB groups. Statistical analysis was based on logistic regression. Odds ratios (OR) and their 95% confidence intervals (CI) were calculated.
Among the 2,161 cases diagnosed, 1,186 were PTB and 705 EPTB. The overall TB incidence had fallen from 79.9/100,000 in 1992 to 27.1/100,000 in 2008, P<.05. The number of EPTB cases decreased more slowly than PTB. EPTB increased from 30.6% of cases in 1991-1996 to 37.6% in 2003-2008 (lymphatic site increased 27%), by trend test P<.05. At multivariate level, being female (OR 2.04; 95% CI: 1.56-2.66) and age (OR 1.02; 95% CI: 1.01-1.022) were associated with EPTB, while alcohol abuse (OR 0.33; 95% CI: 0.20-0.52), smoking habit (OR 0.45; 95%CI: 0.34-0.59), contact with PTB patients (OR 0.57; 95% CI: 0.44-0.76) and BCG vaccination (OR 0.64; 95% CI: 0.44-0.92) had a protective effect. The proportion of female gender and age of patients increased over time, whilst there was a decrease in BCG vaccinated patients.
Whilst there has been a reduction in the overall incidence of TB, the proportion of EPTB increased. The proportional increase in EPTB could be explained by an increase in life expectancy and the predominance of women in the population, and by a decline in BCG vaccinated patients.
描述与肺外结核（EPTB）相关的流行病学和危险因素。
将 1991 年至 2008 年间在一个白种人群中诊断出的结核病（TB）病例分为 EPTB 或肺结核（PTB）。所有病例中，63.7%在专科 TB 病房接受随访。采用标准化的数据收集方案，包括：性别、年龄、卡介苗接种、与 PTB 患者接触、吸烟习惯、酗酒、糖尿病、免疫抑制剂/类固醇和 HIV 状态。比较 EPTB 和 PTB 组之间的这些变量。统计分析基于逻辑回归。计算比值比（OR）及其 95%置信区间（CI）。
在诊断的 2161 例病例中，1186 例为 PTB，705 例为 EPTB。总体 TB 发病率从 1992 年的 79.9/100,000 下降到 2008 年的 27.1/100,000，P<.05。EPTB 病例的数量下降速度比 PTB 慢。EPTB 从 1991-1996 年的 30.6%增加到 2003-2008 年的 37.6%（淋巴部位增加 27%），趋势检验 P<.05。在多变量水平上，女性（OR 2.04；95% CI：1.56-2.66）和年龄（OR 1.02；95% CI：1.01-1.022）与 EPTB 相关，而酗酒（OR 0.33；95% CI：0.20-0.52）、吸烟习惯（OR 0.45；95%CI：0.34-0.59）、与 PTB 患者接触（OR 0.57；95% CI：0.44-0.76）和卡介苗接种（OR 0.64；95% CI：0.44-0.92）有保护作用。女性患者的比例和年龄随着时间的推移而增加，而卡介苗接种患者则减少。
尽管 TB 的总体发病率有所下降，但 EPTB 的比例有所增加。EPTB 的比例增加可以解释为预期寿命的延长和人口中女性的主导地位，以及卡介苗接种患者的减少。
